ToolsCalculators
Emergency Heart Failure Mortality Risk Grade (EHMRG)
7-day mortality risk in acute heart failure presenting to the ED.
Emergency Heart Failure Mortality Risk Grade (EHMRG)
Age
years
Arrived by ambulance / EMS
Systolic blood pressure
mmHg
Heart rate
bpm
Oxygen saturation
%
Creatinine
Potassium
Active cancer
Outpatient metolazone use
Complete the fields above to see the result.
When to use
- Risk-stratifying acute heart failure in the ED to inform admission vs discharge.
Formula
Score = 12 + 2*age + 60(if EMS) - SBP(cap 160) + HR(bounded 80-120) - 2*SpO2(cap 92) + 20*creatinine(mg/dL) + potassium points (<4.0:5, 4.0-4.5:0, >4.5:30) + 45(cancer) + 60(metolazone). Grades by cut points -49, -15.8, 18, 56.6.
Pearls and pitfalls
- Higher grades identify patients unsafe for early discharge.
- This implements the 7-day EHMRG; the EHMRG-ST variant adds ST-depression/troponin for 30-day risk.